Handbook of the Sociology of Mental Health (eBook)

Carol S. Aneshensel is Professor, Department of Community Health Sciences at the Fielding School of Public Health, University of California, Los Angeles.  She specializes in the fields of the sociology of mental health and medical sociology, with an emphasis on the social origins of stress and its impact on depression. Her work spans the life course from adolescence through advanced old age. Her most recent work examines the linkages between the socioeconomic stratification and racial/ethnic segregation of neighborhoods and mental health.  She has received the Leonard I. Pearlin Award for distinguished contributions to the sociological study of mental health and the Leo G. Reeder Award for distinguished contributions to medical sociology from the American Sociological Association.  Jo C. Phelan is Professor of Sociomedical Sciences and Co-Director of the Center for the Study of Social Inequalities and Health at the Mailman School of Public Health at Columbia University. Her broad research focus is on social inequalities, particularly on the interplay between social structural conditions and social psychological processes in producing, maintaining or changing those inequalities. Her current research interests include socioeconomic inequalities as “fundamental causes” of inequalities in health and mortality; public conceptions of mental illness; and stigma, particularly stigma associated with mental illnesses.Alex Bierman is Assistant Professor in the Department of Sociology at the University of Calgary.  His research is broadly concerned with using mental health as a means to illustrate the importance of structural arrangements for individuals’ lives.  His current research interests include examining how social statuses and a life course context intersect to shape the relationship between stressors and mental health.  An additional area of inquiry focuses on exploring the social and psychological mechanisms that may help to explain the relationship between religious involvement and mental health.

Preface to the Second Edition 10
Reference 12
Acknowledgments 14
Contents 16
Contributors 20
Chapter 1: The Sociology of Mental Health: Surveying the Field 24
Mental Illness or Social Construction? 26
Mental Illness as Social Construction 26
The Medical Model 27
The Debate Over Diagnosis 28
The Medicalization of Deviance 31
Social Antecedents of Mental Illness 33
Social Consequences of Mental Illness 36
Overview of the Handbook 38
References 40
Part I: Conceptualizations of Mental Health and Illness 43
Chapter 2: Listening to Voices: Patient Experience and the Meanings of Mental Illness 44
The Triumph of Biological Psychiatry and the Denial of Patient Expertise 47
The Politics of Listening 48
In Their Own Words 51
Unwelcome Careers 53
An Unfinished Agenda 58
References 58
Chapter 3: Mental Illness as Psychiatric Disorder 62
Psychiatry’s Approach to Classifying Mental Illness 63
Types of Psychiatric Illness 66
Schizophrenia and Other Psychotic Disorders 67
Depression and Other Mood Disorders 68
Anxiety Disorders 69
Substance-Related Disorders 70
Disorders in Childhood 71
Dementia and Delirium 72
Clinical Features of Psychiatric Disorders 72
Severity 73
Episode Duration 75
Onset and Illness Course 76
Closing Thoughts 77
References 77
Chapter 4: The Medicalization of Mental Disorder 81
Medicalization 82
Historical Notes on the Medicalization of Mental Disorder 82
The Emergence and Expansion of ADHD 84
The Promotion of Social Anxiety Disorder 85
Bereavement and Depression: Con ? icts with DSM-V 88
A Note on Demedicalization: Homosexuality and the DSM 90
Concluding Remarks 91
References 92
Chapter 5: Public Beliefs About Mental Illness 94
Beliefs About Causes 95
Public Interpretations of Symptoms and the Boundaries of Disorders 98
Beliefs as Barriers to Treatment 99
Stigma and Prejudice 101
Trends in Beliefs, Stigma, and Prejudice 103
Some Influences on Trends 105
The Persistence of Perceived Dangerousness 106
Conclusions 107
References 108
Chapter 6: The Sociological Study of Mental Illness: A Critique and Synthesis of Four Perspectives 113
Etiological Studies 114
Sociological Psychology Studies 117
Social Response Studies 120
Social Constructionist Studies 121
A Synthesis of Perspectives 125
Conclusion 127
References 127
Part II: Methodology 131
Chapter 7: Issues in Mental Health Assessment 132
Brief History of Community Mental Health Assessment 134
Review and Summary of Major Assessment Techniques 138
Diagnostic Instruments 139
Dimensional Instruments 143
Practical Issues in Assessment 145
Sampling Considerations 145
Instrument Selection 146
Instrument Administration 148
Controversies in Mental Health Assessment 150
Maximizing Reliability at the Expense of Validity? 150
Assessment Context 151
Future Directions 151
References 153
Chapter 8: Analyzing Associations Between Mental Health and Social Circumstances 159
Statistical Explanation and Vanishing Association 159
Progressive Adjustment 160
Theoretical Groundwork: Specifying the Association, Explanation, and Model 160
Step 1: Estimating the Total Association 163
Step 2: Adjusting for Precursors 163
Step 3: Adjusting for Mediators 165
Step 4: Revising the Explanation and Model 166
Interaction Modeling 167
External Moderators 168
Multiple and Conditional Regression 168
External Product Terms 170
Statistical Significance and Multicollinearity 171
Statistical Significance and Skewed Outcome Distributions 171
External Critical Points 172
Cautions About Interactions and Critical Points 172
Mean Logs, Geometric Means, and Medians 173
Internal Moderators 174
Internal Moderator Models 175
Internal Critical Point 175
Mediators as Moderators: Structural Ampli ? cation 176
Mean Centering and Average Net Effects 177
Deviation from the Average Net Effect 177
Indirect and Total Effects 178
Graphing Moderated Mediation 179
Conclusion 180
References 181
Part III: The Social Distribution of Mental Health and Illness 182
Chapter 9: Overview of Descriptive Epidemiology of Mental Disorders 183
Historical Overview 184
Data Sources 186
Lifetime Prevalence and Correlates of DSM-IV Disorders 187
Prevalence 187
Age-of-Onset Distributions 187
Cohort Effects 188
Socio-demographic Correlates 188
Twelve-Month Disorders 188
Prevalence 188
Severity 190
Trends 190
Comorbidity Among Disorders 190
Bivariate Cross-Sectional Comorbidity 190
Multivariate Comorbidity 191
Social Consequences 192
Overview 193
References 194
Chapter 10: Age, Aging, and Mental Health 197
Epidemiology of Aging and Mental Health 198
Age and Mental Disorder: Negative Elements of Mental Health 198
Age and Positive Elements of Mental Health 201
Mental Health Inequalities over the Life Course 202
Aging, Mental Health, and the Axes of Strati ? cation 203
Socioeconomic Status 203
Race and Ethnicity 204
Gender 204
Early Origins of Mental Health 206
Theories of Aging and Mental Health 207
Stress Process Theory 208
Linking Stress Process and Life Course Theories 208
Linking Stress Process and Disparities Research 208
Crisis Theory 209
Cumulative Inequality Theory 209
New Directions in Mental Health Research on Aging 210
Concluding Comments 212
References 213
Chapter 11: Social Stratification, Social Closure, and Social Class as Determinants of Mental Health Disparities 218
Publication Trends 219
Classic Studies 220
Gradational Approaches to Social Inequality 222
Defining Dimensions of Social Stratification 222
Relational Approaches 224
Defining Social Closure 224
Defining Social Class 225
Sociological Approaches to Social Inequalities in Mental Health: A Summary 226
Recent Developments 228
Interrelationships 230
Race and Ethnicity 230
Gender 231
Social Selection and Social Causation 232
Directions for Future Research 234
Conclusions 235
References 236
Chapter 12: Social Stratification and Inequality 241
The Distribution of Life Conditions 242
Generic Resources and Proximate Life Conditions 243
Economic Resources 243
Social Capital 245
Power and Authority 246
Civil Rights 248
Stratification, Life Conditions, and Mental Health 249
Social Evaluation Processes 250
Social Comparisons and Reference Groups 250
Social Comparisons and Self-Esteem 251
Relative Deprivation 251
Subjective Social Status 252
Equity and Justice 253
Status Inconsistency 254
Stratification, Social Evaluations, and Mental Health 255
Summary and Future Recommendations 256
References 258
Chapter 13: Race, Nativity, Ethnicity, and Cultural Influences in the Sociology of Mental Health 266
Achieving Conceptual Clarity 267
Defining Race 268
Defining Nativity 269
Defining Ethnicity 269
Defining Cultural Influences 270
Importance of Race, Nativity, Ethnicity, and Cultural Influences for Understanding Mental Health Status 272
Why Assessment of Mental Health Status Depends Upon Sociocultural Variation 274
Social Statuses as Sources of Stress 275
How Predictors of Mental Health Status Link to Sociocultural Variation 276
Implications for Research 277
Intersectionality: Making Sense of Simultaneity 278
Cultural Competencies: Beyond Clinical Applications 279
Control Groups: Comparing Apples to Apples 280
Culture-Bound Syndromes: Evidence for Taking Sociocultural Variation Seriously 281
Conclusion 282
References 283
Chapter 14: Gender and Mental Health 288
Gender Differences in Mental Health by Race and Social Class 289
Gender Conceptions and Practices 290
Gender and Stress 292
Gender and Coping 294
Gender and Social Relationships 296
Gender and Personal Resources/Vulnerabilities 297
Conclusion 298
References 300
Part IV: Social Antecedents 308
Chapter 15: Social Stress in the Twenty-First Century 309
Stressors, Stress, Distress 310
Two Stress Models 311
The Biological Stress Model 311
The Engineering Stress Model 312
Life Change Events: The Model Stressor 313
Chronic Stressors 313
Forms of Chronic Stress 314
The Stress Universe: A Two-Way Classification 314
Daily Hassles 314
Nonevents 316
Traumas 316
Contextual Stressors 316
The Second Dimension 317
Since the Millennium 318
Chronic Stress in the Twenty-First Century 320
Stress in Other Words 321
Work-Family Conflict 322
Discrimination 322
Electronic Connectedness 323
Contextual Stress: The Stress World Moves with the Larger World 323
Traumatic Stressors: History and the Expansion of the Stress Universe 324
The Interdependence of Multiple Stressors 326
Conclusions 326
Still Needed: The Road to Biological Pathways 326
Recent Directions, Future Directions 327
Final Thoughts 328
References 329
Chapter 16: Current Issues and Future Directions in Research into the Stress Process 334
Conceptualizing the Landscape of Stressors 335
Stress Proliferation 337
Resources and Their Mediating/Moderating Functions 339
Coping 339
Social Support 340
Mastery 341
Belief Systems, Values, and Meaning 342
Mental Health Outcomes 344
Discussion 345
References 346
Chapter 17: Social Relations, Social Integration, and Social Support 350
Concepts of Social Support 351
Social Support and Mental Health 351
Main Versus Stress-Buffering Effects of Social Support 352
Conceptual and Empirical Limitations in the Study of Perceived Social Support and Mental Health 353
Spuriousness Due to Personal and Psychological Resources 353
Distinctions Between Perceived, Received, and “Invisible” Support 353
Social Status and Social Support 354
Gender 355
Marital Status 356
Socioeconomic Status 356
Race/Ethnicity 357
Further Considerations 358
Social Integration Versus Relationship Content 358
Negative Aspects of Social Relationships 358
Reciprocity: Giving Versus Receiving Social Support 359
Interventions and Levels of Analysis 360
Conclusions 361
References 362
Chapter 18: Self, Identity, Stress, and Mental Health 366
The Relevance of Self and Identity Issues to Stress and Mental Health 366
Definitions of Self and Identity 367
Symbolic Interactionist Approaches to the Self 368
The Roles of Self/Identity Factors in the Stress Process 369
Stress Appraisal 370
Stress Mediation 373
Stress Moderation 375
Social Support and Coping Processes 377
Areas for Future Research on Selves/Identities and Stress 378
Conclusions 379
References 380
Chapter 19: The Sense of Personal Control: Social Structural Causes and Emotional Consequences 387
The Concept and Measurement of Personal Control 388
Personal Control and Related Concepts 388
Heuristics in Psychology and Sociology 389
Measurement of Personal Control 390
Social Structural Causes of Personal Control 390
Objective Power and Perceived Control 391
Socioeconomic Status 392
Gender, Work, and Family 394
Women’s Work, Men’s Work 394
Work and Family Interactions 395
Gender, Age, and the Sense of Personal Control 396
Age 397
Race and Ethnicity 399
Race 399
Ethnicity 400
Neighborhoods 400
Emotional Consequences of Personal Control 402
Depression and Anxiety 402
Control over Good and Bad Outcomes 403
Feedback Between Personal Control and Depression 403
Various External Attributions 404
Diminishing Returns 404
Conditioning Factors 405
Mediating Factors 405
Social Support and Sense of Control 406
Personal and Universal Control 406
Conclusion 407
References 407
Part V: Institutional Antecedents 411
Chapter 20: Family Status and Mental Health: Recent Advances and Future Directions 412
The Epidemiological Model 414
Marital Status, Gender, and Mental Health: The Evidence 414
Entry into Marriage 415
Divorce and Widowhood 416
Remarriage 417
Cohabitation 418
What Is It About Marriage That Is Beneficial to Mental Health? 418
Economic Resources 419
Social Integration and Social Support 419
Purpose and Meaning 420
Moving Beyond Averages: Heterogeneity in The Effects of Marital Status on Mental Health 420
Marital Quality 421
Race 422
Age and the Life Course 422
Parental Status and Mental Health: The Evidence 423
Transitions to Parenthood and Children 423
Marital Status 424
Gender 425
Adult Children 426
Childless Adults 427
Cumulative Effects of Parenthood on Well-Being 428
Where Do Researchers on Family and Mental Health Go from Here? 428
What Can We Conclude About Family Status and Mental Health? 429
References 430
Chapter 21: The Sociology of Work and Well-Being 439
The Social Structural Explanation of Job Stress 440
Job Conditions and Distress 442
Macroeconomic Structures, Change, and Distress 444
Unemployment 445
The Changing Nature of Work 446
The Changing Labor Market 447
Social Stratification and Job Stress 448
Gender 449
Education 450
Race/Ethnicity 450
Citizenship 451
Work and Family 452
Conclusion and Prospects 454
Limits and Prospects 454
References 455
Chapter 22: Religion and Mental Health 462
Religious Activity 463
A Key Form of Public-Organizational Involvement: Religious Attendance 463
A Key Form of Private-Devotional Religious Involvement: Prayer 466
Religious Belief 467
Beliefs About God 467
Afterlife Beliefs 471
Religion During Times of Stress 471
Religion and Stress Moderation 472
Religious Coping 473
Future Directions 475
References 478
Chapter 23: Neighborhood Context and Mental Health 484
The Measurement and Analysis of Neighborhood Context 485
Objective Indicators of Neighborhood Context 485
Neighborhood Structure 485
Neighborhood Social Organization 486
Neighborhood Disorder 487
Subjective Indicators of Neighborhood Context 487
Neighborhood Experience 487
Analyzing Indicators of Neighborhood Context 487
Neighborhood Context and Mental Health Status 488
Depression 488
Anxiety 489
Psychological Distress 489
Cognitive Functioning 489
Mediators of Neighborhood Context 490
Neighborhood-Level Processes 491
The Neighborhood Experience 491
Secondary Mechanisms 492
Socioeconomic Status 492
Biological Factors 492
Psychological Dispositions 493
Social Resources 494
Health Behaviors 494
Moderators of Neighborhood Context 495
Socioeconomic Status 496
Race and Ethnicity 496
Social Resources 496
Psychological Dispositions 497
Health Behaviors 497
Avenues for Future Research 498
Neighborhood Assessments 498
Mental Health Outcomes 498
Mediation Processes 499
Moderation Processes 499
Selection Effects 499
Model Extensions 500
Conclusion 502
References 502
Part VI: Social Consequences 507
Chapter 24: The Social Dynamics of Responding to Mental Health Problems 508
The Process of Responding to Mental Health Problems 509
Acknowledging the Complexities: Levels of Beliefs, Lines of Acceptable Care, and Pursuing Them in Research 512
What Role Does Culture Play in Modeling Pathways to Care? 514
Acknowledging Complexities: Different Modes of Entry 515
Acknowledging Complexities: Different Systems of Care 516
Acknowledging Complexities: The Rich Variety of Pathways and the Importance of Gateways 518
The Dynamic Social Organization of Mental Health Contacts 520
The Network-Episode Model 520
Pathways of Care: Some Preliminary Results 522
Challenges to the Sociological Study of Service Use: A Move to Understanding Treatment Effectiveness 524
References 525
Chapter 25: Labeling and Stigma 528
Background: The Labeling Debate and Stigma 529
Labeling Theory: Scheff’s Theory and Gove’s Response 529
Modified Labeling Theory 530
Understanding the “Package Deal” 531
Conceptual Advances in and Integration of Stigma Concepts 532
What Is Stigma? 532
How Do Stigmatizing Circumstances Differ from Each Other? 534
Why Do People Stigmatize? 535
Stigma Power: What Do People Gain by Stigmatizing Others? 536
The Exercise of Stigma Power: How Labeling and Stigma Affect the Lives of People with Mental Illnesses 537
Stigma Avoidance and Resistance: How Do People Seek to Counter the Effects of Stigma Power? 539
Future Research 541
Summary and Conclusion 541
References 542
Chapter 26: The Impact of Mental Illness on the Family 545
Mental Illness as a Stressor 546
The Intergenerational Transmission of Mental Illness 547
Early Research on Familial Transmission of Mental Illness 548
Common Mediating Processes 549
Moderating Effects 550
Opportunities for the Sociology of Mental Health 551
The Impact of Psychiatric Illness on Family Caregivers 554
Family Burden 554
Family Caregiving 555
Bringing Sociology Back 556
Mental Illness and the Family in Multilevel Context 558
References 558
Chapter 27: Mental Illness and the Law 564
The Civil Law 565
Involuntary Hospitalization 565
Outpatient Commitment 566
Other Forms of Leveraged Treatment 567
The Criminal Law 568
Arrests 568
Incarceration 570
Criminal Justice Treatment 572
Diversion 572
Mental Health Courts 574
Conclusions and Remaining Questions 575
References 577
Part VII: Social Continuities 584
Chapter 28: Life-Course Perspectives on Mental Health 585
Life-Course Perspectives: Key Principles 586
Long-Term Temporal Patterns 586
The Intersection of Biography and History 588
Linked Lives 588
Human Agency 589
Methodological Advances 589
Relevant Data Sources 589
Statistical Modeling 590
Mental Health in Life-Course Perspective: The Evidence 591
Mental Health Across the Life Course 591
Long-Term Longitudinal Studies 591
Age Differences in Psychiatric Diagnoses and Symptoms 592
The Persisting Effects of Early Traumas and Adversities 593
The Long Arm of Childhood Trauma and Adversity 593
Adult Traumas 594
Mental Illness as a Life-Course Milestone 595
The Consequences of Early Mental Illness for Adult Achievements 595
The Consequences of Early Mental Illness on Adult Mental Health 596
Other Vicissitudes of Life 596
Final Thoughts: Looking to the Future 598
References 599
Chapter 29: Mental Illness as a Career: Sociological Perspectives 603
The Concept of Career 603
Work and Beyond 603
Mental Illness as a Career 605
A Conceptual Model of Mental Illness as a Career 606
Career Pathways 608
Feeling, Thinking, and Acting Badly 608
Illness Onset 610
Help Seeking and Treatment 612
Remission, Recovery, Relapse, and Recurrence 615
Conclusion 617
References 618
Index 621